CD4 / HCV

Mar 11, 2006

Many apologies if this is a duplicate; I didn't see it in the answers posted through today. I may have forgotten to post my email address previously. ===============
In follow up to my previous question about lowering CD4s, two questions. Dr.'s explanation was something along the lines of even without a raging viral load, the virus' very presence is wearing upon you, and thus declining CD4s were inevitable. In fact, he alluded to the notion that my being treated should have been presumed to be inevitable, even after 20 years; thus that "everyone will have AIDS eventually". Without being nave, I would like to think that we don't really know what every long-term non-progressor may or may not do, and like you said in another answer, everyone's biology is different. But he seems to think it's a faît accompli.

Another thought bandied about by other medical professionals is that my >700,000 HCV load may be aggravating my CD4s, and that if I could kick HCV it might help in the long run. I am undergoing a second round of pegintron, this time with ribavirin. My thinking is simply that I agree I do have an obvious problem with HCV and want to try to get it taken care of, while Dr.'s rationale is to "get me ready" for those "inevitable HIV meds", which apparently several of the popular ones work better without coinfection. What are your thoughts on heavy HCV viral load vis à vis declining CD4s? Also, I would mention that they say my "percentages" are good--21 and 20% for the last two. As a reminder from last time, my CD4s over the past year and a half have been 360, 211, 276, and 230; until the 211, I've never been under 325.

Response from Dr. Holodniy

HCV co-infection is definitely associated with increased HIV progression compared to those with just HIV infection.

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